Preventing Deaths from Smoking, Drinking and Violence Means Starting Early - in Childhood

Identifying childhood origins of actual causes of preventable death in the U.S.

In 20022004, Frederick P. Rivara, M.D., M.P.H., and a team of investigators at the University of Washington School of Medicine, with additional collaborators from other institutions, estimated the number of deaths caused by smoking, alcohol use and violence that might be prevented through interventions during childhood and adolescence.

Key FindingsSmoking: from articles in the American Journal of Preventive Medicine and the Journal of Adolescent Health (see the Bibliography):

"The combined effects of a [four-year, national] media campaign and a $1 per pack tax increase will result in a societal savings of between $590,000 per life-year saved and $1.4 million per life year saved "

"Through large-scale multimedia campaigns and a $1 increase in the price per pack of cigarettes, smoking prevalence could be reduced by 26 percent and would result in an annual savings of 108,466 lives and 1.6 million" years of potential life lost.

Alcohol use: from articles in the Journal of Studies on Alcohol, Pediatrics and unpublished papers (see the Bibliography):

"A tax-based 17 percent increase in the price of alcohol ($1 per six-pack of beer) could reduce deaths from harmful drinking by 1,490, equivalent to 3.3 percent of current alcohol-attributable mortality."

"A complete ban on alcohol advertising would have a substantially larger effect, reducing deaths from harmful drinking by 7,609 and resulting in a 16.4 percent decrease in alcohol-related life years lost."

Violence: from an interview with Rivara:

"We found that all the people who are violent offenders have problems with violence as children. The cumulative impact of three simultaneous interventions (nurse home visiting, early childhood education and multisystemic therapy) in childhood or adolescence could potentially reduce 33 percent of all murders, saving 4,182 lives annually and resulting in $5.2 billion lifetime savings in incarceration costs alone."

FundingThe Robert Wood Johnson Foundation (RWJF) provided a two-year $392,217 grant to support this unsolicited project.